National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, 100084, Beijing, China.
Department of Biomedical Engineering, Chinese PLA General Hospital, Fuxing Road, 100853, Beijing, China.
Sci Rep. 2018 Mar 1;8(1):3856. doi: 10.1038/s41598-018-21669-3.
Vagus nerve stimulation (VNS) is an adjunctive treatment for drug-resistant epilepsy (DRE). However, it is still difficult to predict which patients will respond to VNS treatment and to what extent. We aim to explore the relationship between preoperative heart rate variability (HRV) and VNS outcome. 50 healthy control subjects and 63 DRE patients who had received VNS implants and had at least one year of follow up were included. The preoperative HRV were analyzed by traditional linear methods and heart rhythm complexity analyses with multiscale entropy (MSE). DRE patients had significantly lower complexity indices (CI) as well as traditional linear HRV measurements than healthy controls. We also found that non-responders had significantly lower preoperative CI including Area 1-5, Area 6-15 and Area 6-20 than those in the responders while those of the non-responders had significantly lower RMSSD, pNN50, VLF, LF, HF, TP and LF/HF than the responders. In receiver operating characteristic (ROC) curve analysis, Area 6-20 and RMSSD had the greatest discriminatory power for the responders and non-responders, responders and non-responders, respectively. Our results suggest that preoperative assessment of HRV by linear and MSE analysis can help in predicting VNS outcomes in patients with DRE.
迷走神经刺激（VNS）是耐药性癫痫（DRE）的辅助治疗方法。然而，仍然很难预测哪些患者对 VNS 治疗有反应，以及反应程度如何。我们旨在探讨术前心率变异性（HRV）与 VNS 治疗效果之间的关系。我们纳入了 50 名健康对照者和 63 名接受 VNS 植入术且至少随访 1 年的 DRE 患者。通过传统线性方法和多尺度熵（MSE）分析心律复杂度来分析术前 HRV。DRE 患者的复杂度指数（CI）以及传统线性 HRV 测量值明显低于健康对照组。我们还发现，无反应者的术前 CI，包括 Area 1-5、Area 6-15 和 Area 6-20，明显低于有反应者，而无反应者的 RMSSD、pNN50、VLF、LF、HF、TP 和 LF/HF 明显低于有反应者。在接受者操作特征（ROC）曲线分析中，Area 6-20 和 RMSSD 对有反应者和无反应者的区分能力最大，分别为有反应者和无反应者。我们的研究结果表明，通过线性和 MSE 分析对 HRV 的术前评估有助于预测 DRE 患者的 VNS 治疗效果。
